Obstructive sleep apnea (OSA), is the absence of breathing during sleep. It’s a common, chronic disease associated with obesity, and gastric bypass may help.
While obstructive sleep apnea is commonly associated with obese men, it affects a broad cross-section of the population, including overweight women and children, and may also appear in people who are not overweight.
What is OSA?
OSA is a disorder that causes the cessation of airflow through the nose and mouth many times an hour during sleep, which disrupts the sleep cycle and causes loud snoring. The condition is caused by airways that collapse due to fatty deposits in the neck or airway tissues. The usual treatment is the use of a C-PAP (continuous positive airway pressure) machine, which delivers oxygen during sleep.
Sleep apnea and daytime sleepiness and fatigue may be related to insulin resistance, which often accompanies obesity. Because sleep apnea disrupts the normal sleep patterns, patients with this condition may appear depressed, lethargic, and constantly fatigued. The symptoms may be initially misdiagnosed, or the individual may be considered “lazy.”
How can gastric bypass help reduce or eliminate symptoms of OSA?
Weight loss is the best long-term treatment for fighting this condition, and doctors will generally suggest that their OSA patients attempt to lose weight by dieting. Unfortunately, only a few patients with sleep-related breathing disorders succeed in maintaining their weight reduction after dieting. One study found that only 3% of patients with OSA who had a significant improvement in their sleep apnea symptoms after dieting were able to maintain their weight loss after 5 years. In fact, many patients regained all the weight they lost and added more when they tried a low-calorie diet.
Because dietary control has not been successful for long-term treatment of OSA, many doctors are now referring their patients for gastric bypass procedures if their attempts to lose weight through conventional means has failed. Gastric bypass and gastric banding surgeries can cure or control many of the serious diseases that accompany morbid obesity, and many patients with sleep apnea have received relief following their surgery. Most gastric bypass patients do not regain their weight, as dieters often do, so the long-term results tend to be more promising for those suffering from OSA.
Why a sleep study to find OSA is sometimes required before gastric bypass
Because sleep apnea is such a common condition among obese patients of all ages and genders, many obesity clinics require a sleep study for all patients during the workup for bariatric surgery. If the condition is found to be present, patients will be asked to be treated with a C-PAP machine for several months prior to surgery.
Post-gastric bypass patients will be closely monitored if they continue to use the C-PAP machine, because the increased airway pressure could risk the integrity of the surgical site. The new smaller stomach pouch could fill with air at high pressure, causing complications. Some obesity centers will restrict the use of the machine after surgery for this reason. Once the patient has lost weight, the symptoms of sleep apnea will usually go away, and further treatment for the OSA is no longer needed.
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